CDC report card: Good, bad marks on target battles

stethoscope and pen resting on a sheet of medical lab test results, with patient file and x-ray or mri film
(Michael McCloskey 2007)

About three years ago, the nation's top public health agency picked its battles. Now, it's issuing its own report card on reaching those goals: Pretty good but needs improvement.

The seven "winnable battles" singled out by the Centers for Disease Control and Prevention set goals for 2015, such as cutting adult smoking to 17 percent and pushing childhood obesity down to about 15 percent.

The agency released its first progress report Thursday, and CDC officials said they're mostly pleased.

The Atlanta-based CDC, with a budget of more than $10 billion, deals with issues ranging from abortion to zygomycosis infections. In 2010, it started to focus attention and money on six targets: smoking, AIDS, obesity and nutrition, teen pregnancy, auto injuries and infections that spread at hospitals. It later added food safety.

"If you try to tackle everything you achieve nothing," said Dr. Sandro Galea, a Columbia University expert in population health, explaining the rationale.

The interim progress report was designed to help the agency decide where to step up efforts. The CDC has also set three goals for its international work, but those are not covered in the report.

On domestic issues, the report card found:

-Good declines in car accident deaths, teen births and three key types of infections spread at hospitals and other health care facilities.

-Progress in lowering smoking rates and childhood obesity.

-Mixed success on AIDS. More people have been tested and more know about their infection, but no change in estimates of new HIV infections each year.

-No improvement in the arena of food safety.

The CDC set two goals for that battlefront: reduce salmonella infections and E. coli infections. But last year, the rates were as high or higher than before the campaign started.

Experts were quick to note that the CDC doesn't deserve all the credit or the blame for any of these topics.

In food safety, for example, the CDC is responsible for spotting food poisoning outbreaks and quickly getting the word out. But other agencies - like the Food and Drug Administration and the Department of Agriculture - are responsible for food production and preventing germs from getting in food in the first place.

"Public health is a team sport," said Dr. Georges Benjamin, executive director of the American Public Health Association.

Some experts praised CDC for setting goals and making an effort to be accountable. Frieden had done the same thing during his stint as New York City Health Commissioner before taking the CDC post in 2009.

But some wish more ambitious and controversial topics had made the cut. Benjamin said he would like to have seen CDC set a goal for reducing the number of people hurt or killed by gunfire.

Frieden has heard the criticism. "I don't think any of these were low-hanging fruit," he said. "All of these are challenges. The fact that we haven't made tremendous progress on all of them is a reflection of that."